MEDICARE: ADARA JADE PATEL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant
2	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1003617622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADARA JADE PATEL PA-C

Provider Business Mailing Address
First Line	:	7404 KIMBLE CT
Second Line	:
City	:	MONTGOMERY
State	:	TX
Zip	:	77316-3029
Country	:	US
Telephone Number	:	713-419-7222
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 N MACARTHUR BLVD STE 425
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75061-2299
Country	:	US
Telephone Number	:	469-800-1330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2025
Last Update Date	:	03/20/2025

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Directions to “ ADARA JADE PATEL PA-C” Practice Location

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